title: [Hepatitis C virus recurrence after liver transplantation in Hungary. Trends over the past 10 years].
abstract: BACKGROUND
  Management of hepatitis C virus recurrence is a challenge after liver transplantation.
  
  
  OBJECTIVE
  The aim of the authors was to analyse the outcome of liver transplantation performed in hepatitis C virus positive patients during the past ten years and to compare recent data with a previous report of the authors.
  
  
  METHODS
  The authors retrospectively evaluated the data (donors, recipients, perioperative characteristics, patient and graft survival, serum titer of hepatitis C virus RNA, histology) of 409 patients who underwent liver transplantation between 2003 and 2012.
  
  
  RESULTS
  156 patients were transplanted due to hepatitis C virus associated liver cirrhosis (38%). Worse outcome was observed in these patients in comparison to hepatitis C virus negative recipients. The cumulative patient survival rates at 1, 5, and 10 year were 80%, 61%, 51% in the hepatitis C virus positive group and 92%, 85%, 79% in the hepatitis C virus negative group, respectively (p<0.001). The cumulative graft survival rates at 1, 5 and 10 year were 79%, 59% and 50% in hepatitis C virus positive and 89%, 80% and 70% in hepatitis C virus negative patients (p<0.001). Hepatitis C virus recurrence was observed in the majority of the patients (132 patients, 85%), mainly within the first year (83%). The authors observed recurrence within 6 months in 71 patients (56%), and within 3 months in 26 patients (20%). The mean hepatitis C virus recurrence free survival was 243 days. Higher rate of de novo diabetes was detected in case of early recurrence. The cumulative patient survival rates at 1, 3, 5, 10 years were 98%, 89.5%, 81% and 65% when hepatitis C virus recurrence exceeded 3 months and 64%, 53%, 30.5% and 30.5% in patients with early recurrence (p<0.001).
  
  
  CONCLUSIONS
  Poor outcome of liver transplantation in hepatitis C virus positive patients is still a challenge. Hepatitis C virus recurrence is observed earlier after liver transplantation in comparison with a previous report of the authors. De novo diabetes occurs more frequently in case of early recurrence. Despite an immediate start of antiviral treatment, early recurrence has a significant negative impact on the outcome of transplantation.
authors.affiliation: Transzplantációs és Sebészeti Klinika Budapest. fanni.gelley@gmail.com
authors.forename: Fanni
authors.initials: F
authors.lastname: Gelley
authors.forename: György
authors.initials: G
authors.lastname: Gámán
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Gerlei
authors.forename: Gergely
authors.initials: G
authors.lastname: Zádori
authors.forename: Dénes
authors.initials: D
authors.lastname: Görög
authors.forename: László
authors.initials: L
authors.lastname: Kóbori
authors.forename: Imre
authors.initials: I
authors.lastname: Fehérvári
authors.forename: János
authors.initials: J
authors.lastname: Schuller
authors.forename: László
authors.initials: L
authors.lastname: Szőnyi
authors.forename: Péter
authors.initials: P
authors.lastname: Nagy
authors.forename: Attila
authors.initials: A
authors.lastname: Doros
authors.forename: János
authors.initials: J
authors.lastname: Fazakas
authors.forename: Gabriella
authors.initials: G
authors.lastname: Lengyel
authors.forename: Zsuzsa
authors.initials: Z
authors.lastname: Schaff
authors.forename: András
authors.initials: A
authors.lastname: Kiss
authors.forename: Enikő
authors.initials: E
authors.lastname: Sárváry
authors.forename: Balázs
authors.initials: B
authors.lastname: Nemes
mesh_terms: D000208:Acute Disease; D000328:Adult; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome